Systems and methods for implanting surgical implants

ABSTRACT

The present invention relates to an implant system that comprises an implant, a handle configured to removably receive the implant, and, in some embodiments, a spacer tool configured to be mounted on the implant. In further embodiments, a k-wire is employed to guide the implant to a desired location. The handle has a hole for receiving a first portion of the implant. Using the handle to implant the implant, along with an associated spacer, provides a quick and convenient method for implanting the implant as described herein and in the associated drawings.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of priority to U.S. Provisional Patent Application No. 61/651,219, filed May 24, 2012, entitled “System and Methods for Implanting Surgical Implants,” the entire content of which is incorporated by reference herein.

BACKGROUND OF THE INVENTION 1. The Field of the Invention

This invention is in the field of surgical implants and methods for implanting the implants.

2. Background and Relevant Art

Surgical implants can be used to fuse or connect portions of bone together. For instance, surgical implant can connect two bone portions, such as portions of joints together. Hence, the surgical implant can remain implanted (e.g., permanently) in a patient's bone portions. In other instances, surgical implants can connect portions of the same bone together (e.g., a broken or shattered bone) to promote healing. Accordingly, some implants can be removable, for example, after the connected portions of the bone have healed.

The fusion or connection of bones often can be a complex process that takes substantial time and a variety of different instruments and devices in order to successfully insert and implant an implant. Furthermore, oftentimes an operating physician may have a single attempt to successfully implant a permanent or semi-permanent implant. For example, after initial insertion or implantation, some implants cannot be easily removed without damaging the patient's bone. Implanting such implants can be an even more demanding and complex procedure and can require substantial manual dexterity and accuracy from the operating physician preforming the procedure.

Accordingly, it is desirable to find an inexpensive and efficient method for implanting implants.

BRIEF SUMMARY OF THE INVENTION

The present invention relates to an implant system that comprises an implant, a handle configured to removably receive the implant, and, in some embodiments, a spacer tool configured to be mounted on the implant. In further embodiments, a k-wire and an associated driving mechanism for driving the k-wire are employed. The handle has a hole therein for receiving a first portion of the implant. Using the handle to implant the implant, along with an associated spacer, provides a quick and convenient method for implanting the implant as described herein and in the associated drawings.

One embodiment includes an implant system for connecting two or more bone portions. The system has an implant having a first portion, a second portion, and an intermediate portion between the first and second portions. Additionally, the system has a handle configured to be grasped by a user for inserting the second portion of the implant into a first bone portion. Furthermore, the handle has a hole therein that is configured to receive the first portion of the implant. Also, the handle is configured to be removed from the first portion of the implant after inserting the second portion of the implant into the first bone portion.

Another embodiment includes a system for correcting a hammer toe condition by fusing a middle phalanx to a proximal phalanx. The system has an implant having a first barbed portion, a second barbed portion and an intermediate portion between the first and second barbed portions. The system also has a handle having a hole configured to receive the first barbed portion, the handle configured to be grasped by a user. Moreover, the system has a spacer configured to be removably coupled to the intermediate portion of the implant. The second barbed portion of the implant is configured to be inserted into one of said middle phalanx or said proximal phalanx. Also, the first barbed portion of the implant is configured to be removed from the handle and then inserted into the other of said middle phalanx or said proximal phalanx.

Still one other embodiment includes a method for implanting an implant between first and second bone portions. The method includes providing an implant having a first portion, a second portion, and an intermediate portion between the first and second portions. The method also includes providing a handle configured to be grasped by a user. The handle has a hole therein that is configured to receive one or more of the first portion, the second portion, and the intermediate portion of the implant. The method further includes positioning at least a part of the first portion of the implant within the hole of the handle, such that a user can grasp the handle and manipulate the implant with the handle. The method also includes inserting the second portion of the implant into the first bone portion, removing the handle from the first portion of the implant, and positioning the first portion of the implant within the second bone portion.

Additional features and advantages of exemplary embodiments of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by the practice of such exemplary embodiments. The features and advantages of such embodiments may be realized and obtained by means of the instruments and combinations particularly pointed out in the appended claims. These and other features will become more fully apparent from the following description and appended claims, or may be learned by the practice of such exemplary embodiments as set forth hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

In order to describe the manner in which the above-recited and other advantages and features of the invention can be obtained, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. For better understanding, the like elements have been designated by like reference numbers throughout the various accompanying figures. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:

FIG. 1A illustrates a perspective view of an implant system in accordance with one embodiment of the present invention;

FIG. 1B illustrates a perspective view of an implant system in accordance with another embodiment of the present invention;

FIG. 1C illustrates a perspective view of an implant system in accordance with yet another embodiment of the present invention;

FIG. 1D illustrates a perspective view of an implant system in accordance with still one other embodiment of the present invention;

FIG. 2 illustrates a perspective view of a schematic representation of a step of a procedure for severing proximal and middle phalanges of a foot in accordance with one embodiment of the present invention;

FIG. 3 illustrates a perspective view of a schematic representation of another step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one embodiment of the present invention;

FIG. 4 illustrates a perspective view of a schematic representation of still another step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one embodiment of the present invention;

FIG. 5A illustrates a perspective view of a schematic representation of an implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one embodiment of the present invention;

FIG. 5B illustrates a perspective view of a schematic representation of an implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with another embodiment of the present invention;

FIG. 6 illustrates a perspective view of a schematic representation of another implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one embodiment of the present invention;

FIG. 7A illustrates a side view of a schematic representation of a linearly connected proximal and middle phalanges before removal of a spacer from the connection in accordance with one embodiment of the present invention;

FIG. 7B illustrates a side view of a schematic representation of a non-linearly connected proximal and middle phalanges before removal of a spacer from the connection in accordance with another embodiment of the present invention;

FIG. 8 illustrates a perspective view of a schematic representation of a foot after completion of a procedure for connecting proximal and middle phalanges of the foot in accordance with one embodiment of the present invention;

FIG. 9 illustrates a perspective view of an implant system in accordance with still one other embodiment of the present invention;

FIG. 10A illustrates a perspective view of a schematic representation of a step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with another embodiment of the present invention;

FIG. 10B illustrates a perspective view of a schematic representation of a step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with yet one other embodiment of the present invention;

FIG. 11 illustrates a perspective view of a schematic representation of an implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one or more embodiments of the present invention;

FIG. 12 illustrates a perspective view of a schematic representation of another implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one or more embodiments of the present invention;

FIG. 13 illustrates a perspective view of a schematic representation of still another implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one or more embodiments of the present invention;

FIG. 14 illustrates a perspective view of a schematic representation of yet one other implant insertion step of a procedure for connecting proximal and middle phalanges of a foot with an implant in accordance with one or more embodiments of the present invention; and

FIG. 15 illustrates a perspective view of a schematic representation of a foot after completion of a procedure for connecting proximal and middle phalanges of the foot in accordance with one or more embodiments of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention relates to an implant system that comprises an implant, a handle configured to removably receive the implant, and, in some embodiments, a spacer tool configured to be mounted on the implant. In further embodiments, a k-wire and an associated driving mechanism for driving the k-wire are employed. The handle has a hole therein for receiving a first portion of the implant. Using the handle to implant the implant, along with an associated spacer, provides a quick and convenient method for implanting the implant as described herein and in the associated drawings.

The implant system is designed to implant the implant between two bone portions which may be, for example, opposing portions of a joint. The bone portions are prepared for receiving the implant, e.g., by drilling holes to receive the implant. In one embodiment, the first portion of the implant is removably positioned within the handle with the spacer mounted on the implant. A second portion of the implant is then inserted into a first bone portion, such that the spacer abuts an edge of the first bone portion. Thereafter, the handle is removed from the implant. The first portion of the implant, which was previously in the handle, is then positioned within the second bone portion, and, subsequently, the two bone portions are moved together with the spacer remaining therebetween. The spacer provides appropriate spacing between the portions and helps to ensure that the proper portion of the implant is in each bone portion. The spacer is then removed and the bone portions are forced even closer together, with the implant properly placed in respective locations therein to fuse the two bone portions together.

Also, in some embodiments, the implant is barbed on opposing ends, enabling the first portion of the implant to be non-removably inserted within one bone portion, while the second portion is non-removably inserted within another bone portion. The spacer helps to ensure that the second barbed portion of the implant is positioned within the first bone portion, while the first barbed portion of the implant is positioned within the second bone portion, such that the portions of the implant are located in the appropriate bone portions, and such that proper spacing is achieved. In other words, the spacer ensures that a sufficient part of the implant is located within each of the bone portions, such that the implant can securely connect and/or fuse the two bone portions.

Additionally, in one or more embodiments, the implant is a substantially linear implant. Accordingly, the two bone portions connected by linear implant take a substantially linear shape after connection. In other embodiments, however, the implant can be an angled implant, such that the two bone portions connected by the angled implant can form an angled connection.

In another embodiment the implant is a cannulated implant having a passageway therethrough, so as to be properly positioned over a k-wire. Before placing the cannulated implant onto the k-wire, the k-wire is inserted into a bone portion (e.g., at a joint). The first portion of the implant is removably loaded into the handle and, in some instances, a spacer is coupled to the middle portion of the implant (i.e., between barbed portions). Using the handle, the second portion of the implant is fed over the k-wire and into a first bone portion. Then the handle is removed from the implant. The k-wire can be fed into the second, opposing bone portion, and the implant is inserted into the second bone portion. The spacer ensures that the barbed portions of the implant are positioned in the appropriate and respective bone portions. The bone or joint portions are moved together and abut the spacer. Subsequently, the spacer is then removed, and the bone (or joint) portions are moved closer together to facilitate fusion.

In at least one embodiment, the implant system includes a handle preloaded with an implant. The handle and the implant are sterile, such that no further preparation is needed before inserting the second portion of the implant into a first bone portion (i.e., the implant can be immediately inserted into the bone portion). After insertion of the implant, the handle is removed and discarded (e.g., thrown away or sent for recycling or sterilization). Hence, the implant system also can reduce the number of steps required for implanting an implant, for instance, by eliminating the need to position the implant inside the handle.

Referring now to the figures, FIG. 1A illustrates one embodiment of the implant system. In particular, an implant system 10 a, illustrated in FIG. 1A, includes a handle 12 a, an implant 14 a, and a spacer 16 a. Notably, however, in other embodiments, the implant system 10 a may include only the handle 12 a and the implant 14 a (i.e., may not include the spacer 16 a). The handle 12 a has a proximal portion 18 a and a distal portion 20 a. The handle 12 a also has a hole 22 a in the distal portion 20 a thereof. The hole 22 a is configured to accept and facilitate the implant 14 a. More specifically, the implant 14 a can be removably inserted into the hole 22 a. The spacer 16 a also can be removably secured or coupled to the implant 14 a.

The implant 14 a has a substantially linear shape. Accordingly, when used to connect to bone portions, the bone portions connect with the implant 14 a form a substantially linear bone connection. The implant 14 a also has a plurality of interrupted barbs 24 a′, 24 a″ disposed on two opposing sides thereof. In other words, the barbs 24 a′, 24 a″ do not encircle the implant 14 a (as viewed at an end or cross-sectional view of the implant 14 a) and form a section of barbs 24 a′ and one side of the implant 14 a and another section of barbs 24 a″ on an opposite side of the implant 14 a.

The interrupted barbs 24 a′, 24 a″ secure the implant within the bone portions. Particularly, the implant 14 a has a first portion 26 a and a second portion 28 a, each of which has barbs 24 a′, 24 a″ on opposing sides thereof. It should be noted that the terms “first” and “second” portion as used in connect with the implant and bones are designated for descriptive purposes only and shall not be read as limiting. Accordingly, for instance, the terms the “first” and “second” portions of the implant are used interchangeably, unless indicated otherwise. The first and second portions 26 a, 28 a are separated by an intermediate portion 30 a. In at least one embodiment, the intermediate portion 30 a does not have barbs 24 a′, 24 a″.

Additionally, in one embodiment the first portion 26 a is relatively shorter than second portion 28 a. Hence, as further described below, in some instances, the second portion 28 a (i.e., the longer portion) is inserted into the proximal phalanx, while the first portion 26 a (i.e., the shorter portion) is inserted into the middle phalanx. Those skilled in the art should appreciate that the proximal phalanx is typically longer than the middle phalanx and, consequently, can accommodate a longer portion of the implant 14 a. Furthermore, a typical middle phalanx has a larger cross-section than the proximal phalanx, which can accommodate the first portion 26 a that has a larger cross-section than the second portion 28 a. Hence, in some embodiments, the first portion 26 a of the implant 14 a has a bigger cross-section than the second portion 28 a. In other embodiments, however, as further described below, the second portion 28 a can have a larger cross-section than the first portion 26. Also, the first portion 26 a can be relatively longer than the second portion 28 a.

In other embodiments, the implant 14 a can have other configurations. For instance, the implant 14 a can have uninterrupted barbs, which can encircle the implant 14 a. The implant 14 a also can have any number of barbs on either the first portion 26 a, the second portion 28 a, the intermediate portion 30 a, and combination thereof. Furthermore, the barbs can have any number of shapes suitable for securing the implant 14 a within bone. Moreover, in one or more embodiments, in lieu of or in addition to the barbs 24 a′, 24 a″, the implant 14 a can have one or more press-fit sections on the first and/or the second portions 26 a, 28 a, which can be press fitted into bone portions (e.g., the press-fit section of the implant 14 a can form an interference fit within holes in the bone portions).

The intermediate portion 30 a can accept and removably secure the spacer 16 a. Particularly, a slot 32 a can fit over and couple to the intermediate portion 30 a. In the illustrated embodiment, the slot 32 a has a substantially rectangular shape which fits over a corresponding, substantially rectangular shape of the intermediate portion 30 a. Additionally, the spacer 16 a can have a snug or firm fit with the implant 14 a. For example, in at least one embodiment, the spacer 16 a has dimples 34 a, which form an interference fit with the intermediate portion 30 a, thereby firmly securing the spacer 16 a to the intermediate portion 30 a of the implant 14 a. Such snug or firm fit between the spacer 16 a and the implant 14 a can allow the spacer 16 a to remain on the implant 14 a while the implant 14 a is inserted into the bone portions.

Additionally, the spacer 16 a has a grip section 36 a, which can provide better grip for the user. Particularly, the grip section 36 a has multiple serrations, which create an increased surface area of contact between the user's hand and the spacer 16 a, thereby providing a better grip for the user. Hence, the user can secure the spacer 16 a to the implant 14 a more easily. Similarly, the grip section 36 a also can allow the user to remove the spacer 16 a from the implant 14 a more easily.

In other embodiments, the slot 32 a of the spacer 16 a and/or the intermediate portion 30 a of the implant 14 a can have any number of shapes and sizes. For example, the intermediate portion 30 a can have arcuate sidewalls. Similarly, the spacer 16 a also can have at least partially arcuate sidewalls forming the slot 32 a. Accordingly, the spacer 16 a can snap onto the intermediate portion 30 a of the implant 14 a. In other words, as the slot 32 a is fitted over the intermediate portion 30 a, the arcuate sidewalls forming the slot 32 a can deflect around the intermediate portion 30 a and, subsequently, return to their original position when the slot 32 a reaches its final location with respect to the intermediate section 30 a of the implant 14 a. In light of this disclosure, other configurations of the slot 32 a and the intermediate portion 30 a, which can allow the spacer 16 a to be secured to the implant 14 a should be apparent to those skilled in the art.

Thus, when secured to the implant 14 a, the spacer 16 a can ensure proper depth positioning of the first and second portions 26 a, 28 a of the implant 14 a within the bone portions. Additionally or alternatively, the spacer 16 a can help the user to orient the implant 14 a with respect to the bone portion. For instance, in at least one embodiment, the spacer 16 a is positioned substantially orthogonally with respect to the implant 14 a. Accordingly, the user can orient the implant 14 a by orienting the spacer 16 a, which is more visible and can aid the user with properly orienting the implant 14 a before and during insertion thereof into the bone portion.

As noted above, the handle 12 a can secure the implant 14 a within the hole 22 a, such that the user can insert the second portion 28 a of the implant 14 a into a first bone portion (further described below). Accordingly, the hole 22 a has a suitable shape and size that can at least partially accommodate the first portion 26 a of the implant 14 a. Similarly, the implant 14 a has a cross-section with a corresponding shape that fits into the hole 22 a. For example, in some embodiments, the handle 12 a has a rectangular shaped hole 22 a, and the implant 14 a has a cross-section that allows the implant 14 a to fit into the rectangular shaped hole 22 a. As mentioned above, in some embodiments, the lengths and/or width of the first and second portions 26 a, 28 a can be different from each other. Hence, the size and shape of the hole 22 a can be such that accommodates a particular size and shape of the first portion 26 a of the implant 14 a.

Furthermore, the hole 22 a can have a clearance between the walls thereof and the implant 14 a, such that the implant 14 a is loosely secured within the hole 22 a. Alternatively, the hole 22 a can form a snug or press (i.e., interference) fit with the implant 14 a. In any event, the hole 22 a can hold and locate the implant 14 a in a predetermined orientation.

In other embodiments, the hole 22 a can have any number of other shapes, including shapes that also can orient the implant 14 a with respect to the handle 12 a (e.g., by preventing the implant 14 a from rotating within the hole 22 a). For instance, the hole 22 a can have an oval shape that can correspond with the cross-section of and secure the implant 14 a in the handle 12 a, such that the implant 14 a is substantially prevented from rotation within the hole 22 a. Additionally or alternatively, as noted above, the hole 22 a and the implant 14 a can form a snug or press fit. Accordingly, a tight fit between the hole 22 a and the implant 14 a also can prevent the implant 14 a from rotating within the hole 22 a (and the user can position the implant 14 a within the hole 22 a at a desired orientation). Preventing the implant 14 a from rotating with respect to the handle 12 a can help the user to correctly orient and implant the implant 14 a with in the bone portions. In other words, the implant 14 a can have a predetermined orientation with respect to the handle 12 a, such that the user holding the handle 12 a can properly orient the implant 14 a, to a desired orientation with respect to the bone portion.

Additionally, as noted above, at least a portion of the first portion 26 a fits within the hole 22 a. Hence, in some embodiments, the entire first portion 26 a fits within the hole 22 a. In other embodiments, however, some of the first portion 26 a remains outside of the handle 12 a. Moreover, in still further embodiments, at least a portion of the intermediate portion 30 a also fits within the hole 22 a. Thus, for example, the implant 14 a can be inserted into the bone portion without having the spacer 16 a secured thereto.

More specifically, when the entire intermediate portion 30 a is contained within the hole 22 a of the handle 12 a, the distal portion 20 a of the handle 12 a can act as a stop (similar to the spacer 16 a) and can prevent insertion of the implant 14 a into the bone portion beyond the second portion 28 a. In other words, when the second portion 28 a is inserted into the bone portion, the distal portion 20 a of the handle 12 a abuts the bone portion, thereby preventing further insertion of the implant 14 a into the bone portion.

In one or more embodiments, the proximal portion 18 a of the handle 12 a is shaped to facilitate grasping by a user. Such shape can be ergonomically designed to fit in a user's hand. In the illustrated embodiment, the proximal portion 18 a of the handle 12 a has a substantially oval shape and is sized to permit grasping thereof by the user. Additionally, the proximal portion 18 a of the handle 12 a has at least one orientation surface 38 a. More specifically, the orientation surface 38 a forms a substantially flat surface that spans across a large part of the proximal portion 18 a.

In the illustrated embodiment, the orientation surface 38 a is aligned with at least one wall of the hole 22 a, which is, in turn, aligned with a flat land 40 a on the implant 14 a. Consequently, the orientation surface 38 a is also aligned with the flat land 40 a of the implant 14 a. Thus, the user grasping the handle 12 a can use the orientation surface 38 a to orient the flat land 40 a and, therefore, the implant 14 a with respect to the bone portion receiving the first or the second portion 26 a, 28 a of the implant 14 a.

In one or more other embodiments, the handle 12 a can have other shapes and/or features, including features that can help the user to orient the implant 14 a. For instance, the handle 12 a can be substantially round (e.g., can have a cylindrical shape). Similarly, features enabling the user to determine the orientation of the implant 14 a within the handle 12 a can vary from one embodiment to another. For example, the handle 12 a can include a line or another marker that indicates location of the flat land 40 a.

Similarly, in addition to or in lieu of the flat land 40 a, the implant 14 a can include other physical or printed landmarks (visible on the implant 14 a) for aligning the implant 14 a within the handle 12 a. For instance, the implant 14 a can include lines, dots, or other symbols imprinted thereon, which can be aligned with a predetermined location (or locations) on the distal portion 20 a of the handle 12 a. Examples of physical landmarks include dimples, protrusions, and slots. Particularly, the handle also can include a divider that can fit into a slot of the implant, thereby orienting the implant with respect to the handle.

For example, as shown in the embodiment illustrated in FIG. 1B, an implant system 10 b includes a handle 12 b, an implant 14 b, and a spacer 16 b. The handle 12 b, implant 14 b, and spacer 16 b can be substantially the same as the handle 12 a, implant 14 a, and spacer 16 a (FIG. 1A), respectively. Additionally or alternatively (as applicable), however, the handle 12 b and the implant 14 b have other features as further described below. More specifically, for instance, the implant 14 b includes slots 42 b, 44 b.

The slot 42 b is located in a first portion 26 b of the implant 14 b, and divides the first portion 26 b into sections 26 b′ and 26 b″. Similarly, the slot 44 b is located in a second portion 28 b of the implant 14 b and divides the second portion 28 b into sections 28 b′ and 28 b″. Hence, the slots 42 b, 44 b can allow the respective sections 26 b′, 26 b″, 28 b′, 28 b″ to flex or collapse together into a narrower configuration and to spring back to their original configuration. In other words, for example, as the second portion 28 b of the implant 14 b is inserted into a hole made in the bone portion, the sections 28 b′, 28 b″ can collapse to fit into the hole and spring back to their original positions to engage barbs 24 b′ with the hole in the bone portion.

Additionally or alternatively, as noted above, the slot 42 b can help to align the implant 14 b with the handle 12 b. Particularly, the handle 12 b includes a hole 22 b in a distal portion 20 b, and the hole 22 b includes a divider 46 b. Furthermore, the handle 12 b includes a proximal portion 18 b that has an orientation surface 38 b. The orientation surface 38 b has a predetermined position or orientation with respect to the divider 46 b. In the illustrated embodiment, the orientation surface 38 b is positioned orthogonally with respect to the divider 46 b.

The divider 46 b is configured to fit into the slot 42 b (and vice versa). Accordingly, after inserting the implant 14 b into the hole 22 b, the slot 42 b and, consequently, the implant 14 b will have a predetermined orientation with respect to the orientation surface 38 b. Hence, the user can utilize the orientation surface 38 b to position the implant 14 b in a desired orientation with respect to the bone portion receiving the implant 14 b.

Furthermore, the divider 46 b permits relaxed dimensional tolerances for the hole 22 b. Specifically, because the implant 14 b is oriented by positioning the divider 46 b within the slot 42 b, the shape and dimensions of the hole 22 b does not have to closely correspond with the cross-section of the implant 14 b in order to prevent the implant 14 b from rotating. Accordingly, the hole 22 b can have greater clearance between the walls thereof and the implant 14 b, as compared with a hole that does not have a divider that fits into a slot of an implant.

It should be noted, however, that excessive clearance between the implant 14 b and the walls of the hole 22 b can interfere with proper placement of the implant 14 b in the bone portion, as such clearance may allow the implant 14 b to move about the divider 46 b (e.g., in an orthogonal direction with respect to the opening 22 b). Thus, in at least one embodiment, the hole 22 b is configured to hold the implant 14 b such that the implant 14 b has limited amount movement within the hole 22 b. For example, the hole 22 b can have 0.005″ of clearance per side with respect to the implant 14 b (i.e., 0.005″ gap between each of the walls of the hole 22 b and the implant 14 b).

The above description relates to the implant systems that include linear implants 14 a, 14 b (see FIGS. 1A-1B). It is to be appreciated that this invention is not so limited. For example, as illustrated in FIG. 1C, embodiments of the present inventions include an implant system 10 c that has non-linear implant configurations. In particular, the implant system 10 c includes a handle 12 c, an implant 14 c, and a spacer 16 c. In some embodiments, the implant system 10 c does not include the spacer 16 c. The handle 12 c, implant 14 c, and spacer 16 c are substantially the same as the handle 12 a, implant 14 a, and spacer 16 a (FIG. 1A), respectively, except as otherwise described below. For instance, the implant 14 c has other features as further described below. More specifically, a first portion 26 c and a second portion 28 c form an angle 48 with respect to each other about a bend point 50 c.

In one embodiment, the angle 48 is approximately 10 degrees. In light of this disclosure, it should be apparent to those skilled in the art that the angle between the first and second portions 26 c, 28 c can be greater or less than 10 degrees. Nevertheless, it is noted that some angles may be impractical in light of the particular application of the implant 14 c. Accordingly, the angle 48 can be designed as best suited for a particular connection of bone portions.

Thus, the first and second portions 26 c, 28 c remain linear, but form an angle about the bend point 50 c. In the illustrated embodiment, the bend point 50 c is located at the transition point between the first portion 26 c and an intermediate portion 30 c. In other words, the second portion 28 c and the intermediate portion 30 c form a linear segment of the implant 14 c and the first portion 26 c forms another linear segment.

In other embodiments, the bend point 50 can be located anywhere between the first and second portions 26 c, 28 c. The bend point 50 c also can be located at other points along the implant 14 c. Furthermore, the implant 14 c can have other non-linear configurations and may be curved along one or more axes. Similarly, the first and second portions 26 c, 28 c of the implant 14 c can form compound angles with respect to each other—i.e., the first and second portions 26 c, 28 c can be angled with respect to each other along two or more axes. As further described and illustrated below, when connected with a non-linear implant (such as the implant 14 c) two bone portions form a non-linear connection.

Because the implant 14 c comprises two linear segments, which form an obtuse or acute angled therebetween, the implant 14 c can fit into a straight hole 22 c located in a distal portion of the handle 12 c. Alternatively, the hole 22 c can have other configurations, suitable to accept the particular non-linear implant 14 c. For instance, the hole 22 c can be linear and have sufficient clearance therein to accept non-linear sections of the implant 14 c. In other embodiments, the hole 22 c can have a non-linear geometry, which can accommodate a non-linear section (e.g., a non-linear first portion 26 c) of the of the implant 14 c.

Additionally, one or more portions of the implant can have a threaded configuration. For example, as shown in the embodiment illustrated in FIG. 1D, an implant system 10 d includes a handle 12 d, an implant 14 d, and a spacer 16 d. The handle 12 d, implant 14 d, and spacer 16 d can be substantially the same as the handle 12 a, implant 14 a, and spacer 16 a (FIG. 1A), respectively. Additionally or alternatively (as applicable), however, the handle 12 d and/or the implant 14 d have other features as further described below.

For instance, similar to the implant 14 a (FIG. 1A), the implant 14 d has a first portion 26 d (that has multiple barbs) and a second portion 28 d, which is separated from the first portion 26 d by an intermediate portion 30 d. Also, the spacer 16 d fits over the intermediate portion 30 d (as described above in connection with the spacer 16, shown in FIG. 1A). Additionally, however, a second portion 28 d of the implant 14 d includes barbs 24 d′ and 24 d″ that can be threaded into a bone portion. In other words, the barbs 24 d′ and 24 d″ form an interrupted thread (similar to a thread of a screw). The implant 14 d also can have a flat land 40 d, which can help with gripping the implant 14 d as well as holding the implant 14 d during rotation, as the implant 14 d is screwed into a bone portion.

In the illustrated embodiment, the implant 14 d has a substantially linear configuration. It should be noted, however, that this invention is not so limited. For instance, the implant 14 d can have angled configuration (e.g., similar to the implant 14 d, shown in FIG. 1C) or other non-linear configurations. Additionally, the first and/or second portions 26 d, 28 d of the implant 14 d can have slots (similar to the implant 14 b, shown in FIG. 1B).

As described above, the first portion 26 d of the implant 14 d fits into a hole 22 d, located in a distal portion 20 d of the handle 12 d. The hole 20 d holds the implant 14 d, such that the user can screw the second portion 28 d into a bone portion (described below). Additionally, in some embodiments, the hole 20 d can include a divider that can fit into a slot in the implant 14 d and can further assist in preventing the implant 14 d from rotating, when the second portion 28 d is screwed into the bone portion. Furthermore, the hole 20 d can be positioned at an angle with respect to a center axis of the handle 12 d, such that, for instance, when an angled implant 14 d is inserted into the hole 20 d, the second portion 28 d can be substantially aligned with the center axis of the handle 12 d. In other words, rotating the handle 12 d about the center axis thereof will, in turn, cause rotation of the second portion 28 d about a center axis of the second portion 28 d.

As described above, the implant system 10 a, 10 b, 10 c, 10 d can be used to connect and/or fuse two bone portions, and such connections can be substantially linear or non-linear. Particularly, the implant system 10 a can be used to connect and/or reconnect a middle and proximal phalanges of a patient's foot. Thus, as illustrated in FIGS. 2-8, such procedure can be used, for example, to correct a condition known as hammer toe.

Referring now to FIG. 2, in at least one embodiment, to correct the hammer toe condition, illustrated on phalanges 52 of a patient's foot 54, a middle phalanx 56 is first separated from a proximal phalanx 58 of a patient's foot 54. Hence, a joint connecting the middle phalanx 56 to the proximal phalanx 58 is initially exposed by making an appropriate incision in the patient's foot 54. Subsequently, a saw 60 (e.g., a reciprocating saw) is used to separate the middle phalanx 56 from the proximal phalanx 58. It should be noted that FIG. 2 provides a schematic representation of the above step in the procedure. During the procedure, the middle phalanx 56 and the proximal phalanx 58 remain connected with connective tissue, such as skin and tendons.

After separating the middle phalanx 56 from the proximal phalanx 58, a blind hole is made in the proximal phalanx 58, as illustrated in FIG. 3. A drill or a k-wire is used to make the blind hole in the proximal phalanx 58 of the patient's foot 54. In the illustrated embodiment, a drill 62 is used to make the blind hole in the proximal phalanx 58. Additionally, a stopper 64 is secured to the drill 62 to control the depth of penetration of the drill 62 into the proximal phalanx 58. Thus, the drill 62 can drill into the proximal phalanx 58 only up to the stopper 64, thereby creating a blind hole that has a depth approximately equal to the distance between the tip of the drill 62 and the stopper 64.

In another step, schematically illustrated in FIG. 4, a hole also can be drilled in the middle phalanx 56 of the patient's foot 54. Particularly, the drill 62 is used to make the hole in the middle phalanx 56. In some embodiments, the hole drilled in the middle phalanx 56 is a blind hole. However, the depth of the hole in the middle phalanx 56 need not be controlled as closely as the depth of the hole located in the proximal phalanx 58. Accordingly, the at least one embodiment, the drill 62 is used without a stopper. Alternatively, however, a stopper can be used on the drill 62 during drilling of the hole in the middle phalanx 56, and such stopper may prevent over-drilling the hole in the middle phalanx 56.

In still another step, schematically illustrated in FIG. 5A, an implant system is used 10 to insert an implant 14 a, 14 b, 14 c into the proximal phalanx 58. Particularly, the implant 14 a, 14 b, 14 c is held in a handle 12, as described above in connection with FIGS. 1A-1D. The handle 12 is used to insert the implant 14 a, 14 b, 14 c into the hole previously drilled in the proximal phalanx 58. A spacer 16 acts as a stop, preventing insertion of the implant 14 a, 14 b, 14 c into the proximal phalanx 58 beyond a predetermined depth. More specifically, the spacer 16 prevents insertion of the implant 14 a, 14 b, 14 c into the proximal phalanx 58 beyond a length of a second portion of the implant 14 a, 14 b, 14 c.

In alternative implementations the implant can be inserted into the middle phalanx 56, before inserting the implant 14 a, 14 b, 14 c into the proximal phalanx 58. Furthermore, as described above, the insertion of the implant 14 a, 14 b, 14 c into the bone portion (e.g., middle or proximal phalanx 56, 58) can be performed without using the spacer 16. For instance, when the first and intermediate portions are located within the hole of the handle, the distal portion of the handle will abut the proximal phalanx 58, thereby controlling and/or limiting the depth of insertion of the implant 14 a, 14 b, 14 c.

After inserting the implant 14 a, 14 b, 14 c into the proximal phalanx 58, the handle 12 is removed from the inserted implant 14 a, 14 b, 14 c. As noted above, in some embodiments, the handle 12 is disposable. Consequently, after removing the handle 12 from the implant 14 a, 14 b, 14 c, the handle 12 can be discarded. Although the handle 12 is removed from the implant 14 a, 14 b, 14 c, the spacer 16 remains secured to the implant 14 a, 14 b, 14 c.

Alternatively, as illustrated in FIG. 5B, in one or more embodiments, the implant 14 d is screwed into the proximal phalanx 58. In the illustrated embodiment, the second portion of the implant 14 d has barbs that form a thread, which can be screwed into the proximal phalanx 58. In at least one embodiment, the barbs form a right-handed thread on the implant 14 d. Accordingly, the handle 12 together with the implant 14 d are rotated clockwise, to screw the implant 14 d into the proximal phalanx 58. In other embodiments, however, the implant 14 d can have a left-handed thread, and the handle 12 can be rotated counterclockwise, to screw the implant 14 d into the proximal phalanx 58. Furthermore, as the handle 12 rotates, to advance the implant 14 d into the proximal phalanx 58, the spacer 16 can either rotate together with the implant 14 d or can remain stationary (i.e., the implant 14 d can rotate inside of the spacer 16).

Thereafter, the handle 12 is removed from the implant 14 (e.g., from the first portion of any one of the implants 14 a, 14 b, 14 c, 14 e (see Figured 1A-1D)), and the middle phalanx 56 is inserted onto the implant 14, as schematically illustrated in FIG. 6. Namely, the hole previously drilled in the middle phalanx 56 is fitted over the implant 14. Thereafter, the middle phalanx 56 is pushed toward the proximal phalanx 58, such that both the middle phalanx 56 and the proximal phalanx 58 abut the spacer 16 on opposing sides thereof, as illustrated in FIGS. 7A-7B.

Particularly, FIG. 7A schematically illustrates an incomplete linear connection between proximal phalanx 54 a and the proximal phalanx 58 a. As described above, such connection is made using a linear implant, for example, implant 14 a, 14 b, 14 d (FIGS. 1A-1D). By contrast, FIG. 7B schematically illustrates a non-linear connection made between middle phalanx 56 b and proximal phalanx 58 b. The non-linear connection is made using a non-linear implant, for example, implant 14 c, 14 d (where the implant 14 d is angled).

In both instances, the spacer 16 initially remains between the middle phalanx 56 a, 56 b and the proximal phalanx 58 a, 58 b, to ensure that the respective first and second portions of the implant 14 a, 14 b, 14 c, 14 d (as applicable) remain in appropriate bone portions (FIGS. 7A-7B). In other words, the spacer 16 ensures that the first portion of the implant 14 a, 14 b, 14 c, 14 d is inserted in the middle phalanx 56 a, 56 b. Similarly, the spacer 16 also ensures that the second portion of the implant 14 a, 14 b, 14 c, 14 d is inserted in the proximal phalanx 58 a, 58 b.

A linearly connected middle phalanx 56 a and proximal phalanx 58 a can form a corrected toe 68 a that points substantially straight and outward (FIG. 7A). In contrast to the linear connections, in the non-linear connection between the middle phalanx 54 b and the proximal phalanx 58 b, a corrected toe 68 b points downward (FIG. 7B). In some instance, depending on the patient's foot, a downward pointing corrected toe (e.g., corrected toe 68 b) creates a more natural toe position. Accordingly, depending on the patient's foot, a linear implant, a non-linear implant, or a combination thereof can be used to ensure proper position and orientations of the patient's toes.

Subsequently, the spacer 16 is removed and the middle phalanx 56 and proximal phalanx 58 are further pushed closer together, thereby closing the gap previously occupied by the spacer 16 and forming a corrected toe 68, as illustrated in FIG. 8. FIG. 8 also schematically illustrates the difference between the corrected toe 68 and toes 52 afflicted with the hammer toe condition. Particularly, FIG. 8 illustrates linearly connected middle phalanx 56 and proximal phalanx 58, forming the corrected toe 68.

In the above described embodiments, the implant system includes a handle, an implant, a spacer, and/or combinations thereof. However, this invention is not so limited. In at least one embodiment, the implant system includes additional components. For example, as illustrated in FIG. 9, an implant system 10 e includes a handle 12 e, an implant 14 e, a spacer 16 e, and a k-wire 70. The handle 12 e, implant 14 e, and spacer 16 e can be substantially the same as the handle 12 a, implant 14 a, and spacer 16 a (FIG. 1A), respectively, except as otherwise described below. Particularly, the handle 12 e and the implant 14 e have certain features that distinguish the handle 12 e and the implant 14 e from the handle 12 a and implant 14 a (FIG. 1A). For example, the implant 14 e includes a passageway 72 therethrough.

Similar to the implant 14 a (FIG. 1A), the implant 14 e has a first portion 26 e and a second portion 28 e. In at least one embodiment, the first portion 26 e is relatively longer than the second portion 28 e. Furthermore, the first portion 26 e has a smaller cross-section than the second portion 28 e. Accordingly, in some embodiments, as noted above, the second portion 28 e (i.e., the shorter portion) is inserted into the middle phalanx, and the first portion 26 e (i.e., the longer portion) is inserted into the proximal phalanx. In other embodiments, (e.g., as described above) the implant 14 e can have the first and second portions 26 e, 28 e that have any number of other dimensional relationships with respect to each other.

The passageway 72 accommodates the k-wire 70, which has a cylindrical shape, and allows the k-wire 70 to pass therethrough. The passageway 72 is substantially round and has a slight clearance for the k-wire 70 to pass, such that the k-wire 70 can provide location for the implant 14 e, as the implant 14 e slides over the k-wire 70. For example, the passageway 72 can have a total of 0.004″ (i.e., 0.002″ per side) clearance with respect to the k-wire 70. In other words, an outside diameter of the k-wire 70 can be 0.004″ smaller than an inside diameter of the passageway 72.

In other embodiments, the k-wire 70 and/or the passageway 72 can have other shapes and configurations. For instance, at least a part of the k-wire 70 and/or the passageway 72 can have a polygonal shaped cross-section, such as a rectangular cross-section. Such cross-section also can aid in properly orienting the implant 14 e with respect to the bone portions being connected thereby. Furthermore, in some embodiments, the passageway 72 can have a greater or lesser clearance than 0.004″ with the k-wire 70.

Moreover, in the illustrated embodiment, the passageway 72 is positioned along a centerline of the implant 14 e. However, it is to be appreciated that this invention is not so limited. Hence, the passageway 72 can be located off center (i.e., not aligned with the centerline of the implant 14 e).

Additionally, the handle 12 e is configured to accommodate the k-wire 70. In particular, during the installation (i.e., insertion) of the implant 14 e, the implant 14 e is guided over the k-wire 70. While the implant 14 e is guided over the k-wire 70, the implant 14 e is held in the handle 12 e (as described above in connection with the implant system 10 a of FIG. 1A). Accordingly, in some embodiments, at least a portion of the k-wire 70 enters the handle 12 e during the installation.

Furthermore, a hole 22 e (located in a distal portion 20 e of the implant 14 e), can have an opening sized to accept the k-wire 70. More specifically, the opening can have a similar clearance between the walls thereof and the k-wire 70 as described above in connection with the passageway 72. Thus, the opening can locate or align the handle 12 e with respect to the k-wire 70, thereby providing an additional guide for moving the handle 12 e (together with the implant 14 e) into a desired position (i.e., into a bone portion). Similar to the hole 22 a (FIG. 1A), the hole 22 e is sized and shaped such as to accept at least a part of the first portion 26 e of the implant 14 e.

The method of connecting and/or reconnecting bone portions described above in connection with FIGS. 2-9 relates to linear and non-linear connections made using an implant without a k-wire. This invention, however, is not so limited. For example, as illustrated in FIGS. 10A-15, procedure of connecting two bone portions (e.g., bone portions opposing a joint) with the implant can include insertion of a k-wire into one or both bone portions. Particularly, FIGS. 10A-15 schematically illustrate steps of a procedure for correction of the hammer toe condition in the patient's foot 54, after the middle phalanx 56 and the proximal phalanx 58 have been detached one from another (the detachment is illustrated in FIG. 2 and described in corresponding text above). In other words, the following description relates to reconnecting the middle phalanx 56 and the proximal phalanx 58 using the implant, such as the implant 14 e (FIG. 9).

Referring now to FIG. 10A, in one embodiment, the k-wire 70 is driven into the middle phalanx 56. More specifically, the k-wire 70 is driven into the middle phalanx 56 from the joint side of the middle phalanx 56 (i.e., at the partition between the middle phalanx 56 and the proximal phalanx 58). Alternatively, the k-wire 70 may be driven through the middle phalanx 56 from the side of a distal phalanx 74, as schematically illustrated in FIG. 10B. Hence, in at least one embodiment, the k-wire 70 passes through the middle phalanx 56 and comes out of the distal phalanx 74.

After the k-wire 70 is driven through the middle phalanx 56 and, in some instances, through the distal phalanx 74 of the foot 54, the implant 14 e is guided over the k-wire 70 into position, as schematically illustrated in FIG. 11. In some embodiments, the same k-wire can remain in the middle phalanx 56 and in the distal phalanx 74 as the k-wire that was used to penetrate the middle phalanx 56 and the distal phalanx 74. In alternative embodiments, a k-wire of a smaller diameter (than the k-wire used for penetration) is inserted after removing the k-wire that was used for penetrating the middle phalanx 56 and the distal phalanx 74. In any event, at least one k-wire 70 remains within the middle phalanx 56 and the implant 14 e is guided over the k-wire 70 into an appropriate position.

More specifically, the implant system 10 e is used to reconnect the middle phalanx 56 and the proximal phalanx 58 of the foot 54. The handle 12 e holds the implant 14 e, which has the spacer 16 e secured thereto. The handle 12 e is used to guide the implant 14 e over the k-wire 70 and into the middle phalanx 56. In one embodiment, the second portion of the implant 14 e fits into a recess or hole formed by or around the k-wire 70. Similar to the procedure described above in connection with FIGS. 2-8, the spacer 16 e can be omitted during insertion of the implant 14 e into the middle phalanx 56.

After the implant 14 e is inserted into the middle phalanx 56, the handle 12 e is removed and can be disposed. Subsequently, in one or more embodiments, the spacer 16 e remains secured to the implant 14 e, as schematically illustrated in FIG. 12. At this point in the procedure, the first portion of the implant 14 e is exposed, while the second portion of the implant 14 e is implanted in the middle phalanx 56. The exposed first portion of the implant 14 e is subsequently implanted into the proximal phalanx 58. Additionally, the k-wire 70 also can protrude through the implant 14 e.

Subsequently, for example, as illustrated in FIG. 13, in at least one embodiment, the k-wire 70 is fitted into the proximal phalanx 58. Thereafter, the middle phalanx 56 together with the implant 14 e and the spacer 16 e are pushed toward the proximal phalanx 58, thereby driving and implanting the first portion of the implant 14 e into the proximal phalanx 58, and forming a corrected toe 68 e as schematically illustrated in FIG. 14. After the proximal phalanx 58 and the middle phalanx 56 are pushed together, the spacer 16 e remains between the middle phalanx 56 and the proximal phalanx 58 for a time. As noted above, the spacer 16 e ensures that the first and second portions of the implant 14 e are implanted in the proximal phalanx 58 and in the middle phalanx 56, respectively.

Subsequently, the spacer 16 e is removed and the middle phalanx 56 and proximal phalanx 58 are further pushed together to close the gap previously occupied by the spacer 16 e. As illustrated in FIG. 15, after the gap between the middle phalanx 56 and proximal phalanx 58 is closed, the corrected toe 68 e faces substantially straight outward. As mentioned above, in some instances, the patient's foot 54 may have a more natural structure if the corrected toe 68 e points slightly downward. Such downward orientation can be achieved by using a non-linear implant (described above). Alternatively, in some embodiments, such downward orientation of the corrected toe 68 is achieved by slightly bending the k-wire 70, thereby forcing at least the distal phalanx 74 downward.

In one or more embodiments, the k-wire 70 remains in the middle phalanx 56 and/or in the proximal phalanx 58 after completion of the procedure and is removed after the patient's 54 foot has healed. Alternatively, however, the k-wire 70 can be removed essentially immediately after the procedure is completed (i.e., after the middle phalanx 56 and the proximal phalanx 58 are pushed together to close the gap previously occupied by the spacer 16. Accordingly, the k-wire 70 can be used to guide the implant 14 e into an appropriate position and/or to facilitate healing of the corrected toe 68 in a particular orientation (e.g., with the distal phalanx 74 facing more downward).

The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes that come within the meaning and range of equivalency of the claims are to be embraced within their scope. 

1.-27. (canceled)
 28. A system for connecting two bones comprising: an implant including a flat land, a slot, and defining a passageway configured to accept a k-wire; and a handle configured to be grasped by a user for inserting the implant into a first bone, the handle including; a body having a proximal portion that defines an oval opening with at least one substantially flat surface of the body; a hole defined by a distal end of the handle configured to receive a portion of the implant, the hole being further defined by a divider sized and configured to be received within the slot of the implant so as to orient the implant such that the substantially flat surface is aligned with the flat land of the implant when the portion of the implant is received within the hole; wherein the handle is configured to be removed from the portion of the implant after inserting the implant into a first bone portion.
 29. The system as recited in claim 28 wherein the implant is arranged in a predetermined orientation when engaged by the body within the hole.
 30. The system as recited in claim 28 wherein the at least one surface is aligned with at least one wall that defines the hole and the flat land of the implant.
 31. The system as recited in claim 28 wherein the k-wire is arranged so as to pass through the implant to thereby guide the implant.
 32. The system as recited in claim 28 further comprising a removeable spacer secured to a portion of the implant.
 33. The system as recited in claim 32 wherein the spacer is configured to prevent insertion of the implant into the first bone portion beyond a predetermined distance.
 34. The system as recited in claim 32 wherein the spacer is configured to prevent insertion of the implant into a second bone portion beyond a predetermined distance.
 35. The system as recited in claim 29 wherein the handle further comprises a landmark that corresponds with a preferred orientation of the implant.
 36. A system for correcting a hammer toe by fusing a middle phalanx to a proximal phalanx, comprising: an implant having a slotted first barbed portion, a second barbed portion, and a flat land; a handle having a body that defines a divided hole configured to receive the first barbed portion, a proximal portion of the body having an oval shape defined by at least one substantially flat surface configured to be received within the slotted first barbed portion and wherein the substantially flat surface is aligned with the flat land of the implant when the first slotted barbed portion of the implant is received within the hole; a removable spacer coupled to the implant, the spacer comprising serrations and a dimple configured to form an interference fit with the implant, wherein the second barbed portion is configured to be secured within at least one of the middle phalanx and the proximal phalanx and the first barbed portion is configured to be removed from the handle and then inserted into the other of the middle phalanx or the proximal phalanx.
 37. The system as recited in claim 36 wherein the implant is defined by an angle formed between the first slotted barbed portion and the second barbed portion.
 38. The system as recited in claim 36 wherein the implant defines a cannula having a passageway configured to accept a k-wire.
 37. The system as recited in claim 36 wherein the second barbed portion comprises a plurality of barbs forming a thread.
 38. The system as recited in claim 36 wherein the hole of the handle is further configured to prevent the implant from rotating when the implant is secured within one of the at least middle phalanx and the proximal phalanx.
 39. A method for locating an implant between a first bone and a second bone portions, the method comprising: providing an implant including a flat land, a slot, and defining a passageway configured to accept a k-wire; providing a handle configured to be grasped by a user for inserting the implant into a first bone, the handle including; a body having a proximal portion that defines an oval opening with at least one substantially flat surface of the body; a hole defined by a distal end of the handle configured to receive a portion of the implant, the hole being further defined by a divider sized and configured to be received within the slot of the implant so as to orient the implant such that the substantially flat surface is aligned with the flat land of the implant when the portion of the implant is received within the hole; providing a spacer configured to be removably coupled to the intermediate portion of the implant, wherein the spacer comprises serrations; positioning a portion of the implant within the hole of the handle, such that a user can grasp the handle and manipulate the implant with the handle; inserting a second portion of the implant into the first bone portion; removing the handle from the first portion of the implant; and positioning the first portion of the implant within the second bone portion.
 40. The method as recited in claim 39 wherein the implant has barbs on the first portion and on the second portion.
 41. The method as recited in claim 39 wherein the hole is configured to hold the implant in a predetermined orientation.
 42. The method as recited in claim 41 wherein the handle has at least one orientation surface that defines the orientation of the implant.
 43. The method as recited in claim 42 further comprising using the orientation surface of the hand to orient the second portion of the implant with respect to the first bone portion.
 44. The method as recited in claim 21 wherein the implant is a cannulated implant having a passageway therethrough, and wherein the passage is configured to accept a k-wire. 